Iron Deficiency Alarm: Signs and Conditions We Shouldn’t Ignore

Iron is a mineral whose main role in the body is oxygen transport. Additionally, iron participates in DNA synthesis, is an essential element in mitochondrial energy production, and is part of proteins involved in collagen synthesis, the amino acid tyrosine, and catecholamine neurotransmitters. Adults have approximately 45–55 mg/kg of iron in their bodies, depending on sex. According to the World Health Organization, iron deficiency is one of the most common forms of malnutrition and represents a significant public health problem. Of the iron consumed through food, only a small percentage is absorbed. On average, we ingest 10–20 mg of iron per day from food, but only 1–2 mg is absorbed.

Conditions and Diseases Often Associated with Iron Deficiency

Iron deficiency is not always caused solely by insufficient intake of iron-rich foods. It is crucial to pay attention to certain situations and conditions that increase iron requirements, especially when daily intake alone is insufficient.

Pregnancy
During pregnancy, the mother’s blood volume increases, and the fetus develops, significantly raising iron requirements—approximately an additional 1 g for both mother and fetus combined. In mild deficiency, iron is prioritized for the fetus, but in moderate or severe deficiency, there may be insufficient iron for the fetus. Iron deficiency can negatively affect the fetus, causing low birth weight, preterm birth, and potential cognitive consequences.

Adolescence
Adolescence involves many physiological changes that require higher intake of nutrients, including iron. Adolescents are therefore prone to iron deficiency and anemia. Iron deficiency in this age group can cause impaired mental and physical development, reduced endurance and mental focus, and poorer academic performance. It also negatively affects the immune system, reducing overall resistance to infections.

Menorrhagia
Heavy or prolonged menstrual bleeding (menorrhagia), which is common among women of reproductive age, is a major cause of iron deficiency. Researchers estimate that two-thirds of women with menorrhagia are anemic, and this number is likely higher in countries with compromised food security.

Sports and Physical Activity
Iron is critical for oxygen transport and cellular energy production, making it essential for physical performance. The prevalence of iron deficiency among athletes is 15–35% in women and 3–11% in men. Exercise increases hepcidin levels, the hormone that regulates iron absorption, leading to decreased iron uptake from the gut. Additional factors include increased muscle activity, sweating, hemolysis, and gastrointestinal bleeding.

Vegetarian Diets
A vegetarian diet can meet energy and nutrient needs if it includes a variety of foods. While total iron intake may be similar to omnivorous diets, the type of iron differs. Plant-based foods contain non-heme iron, which is less efficiently absorbed than heme iron from animal sources.

Malabsorption
Gastrointestinal conditions such as celiac disease, Crohn’s disease, and ulcerative colitis can lead to iron deficiency due to reduced absorption from food. Inflammatory bowel disease can also cause bleeding, further depleting iron stores. Malabsorption may also occur after surgical procedures such as gastrectomy.

Signs That Point to Iron Deficiency

Mild iron deficiency may not always cause symptoms, but moderate to severe deficiency and anemia present various signs depending on severity and duration. Common symptoms include:

• Fatigue and Weakness: Feeling lethargic and lacking energy is one of the first signs. Oral iron supplementation in anemic individuals has been shown to significantly reduce fatigue, highlighting the importance of early recognition and treatment.

• Paleness: Pale skin and mucous membranes are classic symptoms. Reduced oxygen levels cause vasoconstriction, primarily in the skin and mucous tissues, to redirect blood flow to vital organs.

• Rapid Breathing and Palpitations: Low oxygen levels trigger faster breathing and tachycardia. Feeling your heart racing or quickly tiring from simple activities can be a warning sign of low iron.

• Headaches: Chronic daily headaches, especially in severe anemia, may be linked to iron deficiency. Iron is involved in regulating neurotransmitters such as serotonin and dopamine, and changes in dopaminergic function may trigger migraines.

• Behavioral Changes: Iron deficiency can cause irritability, nervousness, decreased concentration, and cognitive decline. It may also trigger unusual cravings for non-food items such as ice or soil (pica).

• Cold Hands and Feet: Persistent coldness may result from low iron affecting thyroid hormones, which regulate body temperature.

• Brittle Nails and Hair, Cracked Mouth Corners: Women with iron deficiency may notice hair loss and fragile nails. In advanced anemia, spoon-shaped nails (koilonychia) may appear.

Natural Solution for Iron Deficiency – Floradix®

Floradix® is a well-known iron supplement. This liquid supplement is a safe source of iron for everyone, especially pregnant and breastfeeding women, children, adolescents, older adults, recovering patients, and active individuals. Floradix® contains organic ferrous iron (iron gluconate) that is easily absorbed in the digestive tract and gentle on the stomach, vitamin C to improve absorption, B vitamins to support normal energy metabolism, and herbal extracts. It is free from alcohol, preservatives, colorings, artificial flavors, and lactose, and is suitable for vegetarians.

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References:

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• Polin V, et al. "Iron deficiency: from diagnosis to treatment." Digestive and Liver Disease (2013): 803–809.

• DeLoughery TG. "Iron Deficiency Anemia." Medical Clinics of North America (2017): 319–332.

• Aabdien M, et al. "Epidemiology of iron deficiency among adolescents aged 10–19 years old in Qatar: a cross-sectional study." BMJ Open (2022); 12(12).

• Munro MG. "Heavy menstrual bleeding, iron deficiency, and iron deficiency anemia: Framing the issue." Int J Gynecol Obstet (2023): 7–13.

• Sim M, et al. "Iron considerations for the athlete: a narrative review." Eur J Appl Physiol (2019): 1463–1478.

• Venderley AM, Campbell WW. "Vegetarian diets: nutritional considerations for athletes." Sports Medicine (2006): 293–305.

• Mahadea D, et al. "Iron Deficiency Anemia in Inflammatory Bowel Diseases—A Narrative Review." Nutrients (2021): 4008.

• Singh RK, et al. "Association between iron deficiency anemia and chronic daily headache: A case-control study." Cephalalgia (2023): 43(2).